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ToxIndex - A tool to compare Poisoning Risks of Toxic Agents

Objective:

Poisons centres (PC) play an increasing role in toxicosurveillance, i.e. the detection of new poisoning risks and trends. If a signal indicating a new poisoning risk is detected there is often need for quantitative evaluation. A simple algorithm was developed and applied to describe and compare poisoning risks of products based on PC exposure data.

ToxIndex was defined as the sum of all cases classified as lethal, severe or moderate divided by the number of all exposure cases. Subsets of cases selected by product category and patient age were analysed.

number of all cases classified as lethal, severe or moderate

ToxIndex = –––––––––––––––––––––––––––––––––––––––––––––––––––––––

number of all exposure cases related to a selected agent group

Results:

In total, 31,154 exposure cases were included. The ToxIndex for all exposures was calculated to be 13%. ToxIndex for selected product groups are listed in Table 1. Drugs of abuse are the most risky product group, while exposures to homeopathic drugs very rarely lead to more than minor symptoms.

Conclusion

ToxIndex, i.e. the proportion of more-than-minor-grade poisoning cases of all exposures, is a simple tool to identify and compare poisoning risks in product groups. Based on ToxIndex for wider product groups (as presented here) the poisoning risk for selected subgroups or single products can also be evaluated: ToxIndex for liquid laundry detergent capsules was 13% compared to 3% for all laundry detergents.

History

Toxindex, earlier called IntoxIndex, was used in the past for analysing poisoning risks of different product groups by GIZ-Nord Poisons Center.

Furthermore, scoring systems using the ToxIndex defintion but was not named was used for other analyses by poisons centres and authorities.

ToxIndex was presented and recommended as a tool with a broad field of applications at the EAPCCT Congress in Copenhagen 2013: